9 - Mucosal colour changes Flashcards
What are the causes of oral white lesions?
8
- hereditary
- smoking
- frictional
- lichen planus
- candidal leukoplakia
- carcinoma
- GVHD
- lupus erythematous
Why are white lesions white?
- tissues have normal pink colour from connective tissue and blood vessels
- increase in keratin thickness makes the tissue more opaque and presents as white
- less blood in the tissues presents as white
Define leukoplakia.
- a white patch that cannot be scraped off or attributed to any other cause
- diagnosis of exclusion
What causes frictional keratosis?
Parafunction, thickening of the keratin layer of the mucosa
What causes smokers keratosis?
Thermal trauma from the smoke causing thickening of the keratin layer of the mucosa
What is hereditary keratosis?
- know as white sponge naevus
- white lesions found in areas of mucosa not subject to trauma
- fluid accumulates between layers of epithelium
- begins in childhood
- runs in families
What can cause a chemical burn to the mucosa?
2
- aspirin
- alendronic acid
What causes hairy leukoplakia?
EBV
Describe pseudomembranous candidiasis.
- white patches that can be scraped off mucosa
- known as thrush
- can bleed under where white patches were present due to inflammation
When should you refer a white lesion?
- if the lesion is red and white, focus on red lesion when deciding to refer
- is lesion is raised and thickened
- if the lesion appears to have no cause
What areas are of concern when a white patch appears?
3
- lateral tongue
- anterior FOM
- soft palate
Why do red lesions present red?
- increased blood flow through inflammation or dysplasia
- reduced thickness of epithelium
Define erythroplakia.
- unexplained red change that cannot be attributed to any other cause
- requires biopsy due to malignancy concern
Why are lesions red/blue?
- dark = slow moving blood
- light = clear fluid, saliva or lymph
What is a haemangioma?
- red lesion commonly found on the side of the tongue
- vascular so can increase in size and shrink
What is a lymphangioma?
Cavernous vesicle commonly found on tongue
What vasculitic diseases can present with erythematous lesions?
4
- giant cell arteritis
- polyarteritis nodosa
- kawasaki disease
- granulomatosis with polyangiitis
Why are some lesions pigmented?
- exogenous (coffee, chlorhexidine, bacterial overgrowth)
- intrinsic (racial, melanotic macule, melanoma, melanocytic naevus)
- foreign body (amalgam)
Define melanotic macule.
- freckle
- one melanocyte produces excess melanin
Define melanocytic naevus.
Too many melanocytes in one area producing normal amounts of melanin
What are the signs of melanoma?
- variable pigmentation
- irregular outline
- raised surface
- symptomatic (itchy or bleeding)
